Abstract
AimThree weeks paclitaxel and carboplatin has been considered the standard of care for primary treatment of ovarian cancer (OC). Whether weekly therapy will further improve the clinical outcomes or not is still unclear. We conducted a meta-analysis to compare the two regimens.MethodArticles were selected with a systematic approach, using PubMed databases. Trials concerning comparison between carboplatin plus weekly paclitaxel (dose-dense regimen) and carboplatin plus paclitaxel every 3 weeks were considered. Outcomes included overall survival (OS), progression free survival (PFS) and severe acute toxicity.ResultsDose-dense regimen was associated with significant improvement of PFS compared with standard schedule, with HR of 0.73 (95% CI 0.61-0.88, p = 0.001). There was no difference in OS between treatment regimens (HR 0.95, 95% CI 0.77-1.16, p=0.06), as well as in term of severe acute toxicity.ConclusionDose-dense regimen is superior to standard schedule in terms of PFS. Further studies are necessary to firmly confirm this evidence in advanced OC treatment.
Highlights
Paclitaxel and carboplatin regimen is considered the standard of care for patients with newly diagnosed ovarian cancer (OC) [1]
Dose-dense regimen was associated with significant improvement of progression free survival (PFS) compared with standard schedule, with hazard ratio (HR) of 0.73
There was no difference in overall survival (OS) between treatment regimens (HR 0.95, 95% confidence intervals (CIs) 0.771.16, p=0.06), as well as in term of severe acute toxicity
Summary
Paclitaxel and carboplatin regimen is considered the standard of care for patients with newly diagnosed ovarian cancer (OC) [1]. It is recommended an intravenous infusion of 3-hour paclitaxel 175 mg/m2 and carboplatin at an area under the curve (AUC) of 6 mg/ml/min repeated every 3 weeks for six cycles. In attempt to improve clinical outcomes, based on the efficacy demonstrated in breast cancer [2], new schedules have been tested, including dose-dense regimen. It consisted of weekly paclitaxel plus carboplatin given every 3 weeks. At present, there is no data indicating which regimen is superior
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